Chapter 148 - Return to the Past
She is home now. I collected her from the hospital last Wednesday morning after 8 nights in our local Hilton. The surgeon removed the clamps (stitches were not used) from her skin graft at Tuesday lunchtime while she was under general anaesthetic. His experience removing the melanoma decided him to work on a stable leg. Her Caring Physician may have cast doubts though; he believes that neurological patients should not be anaesthetised; but I suppose it is a matter of draining the swamp while ignoring the crocs.
Did I mention that she developed a slight cough on Friday 31st after a sleepless night? Concerned, I brought in her bouncing ping-pong ball lung exerciser given to her for breathing exercises when she had her kidney operation down in Hot Air City. When a nurse saw/heard her using the device she was told that she could have asked for one as they have them in stock. That is certainly pro-active nursing.
Last Saturday she mentioned to the nurse that her bum area was very tender. Initially ignored, closer inspection revealed 4 small "splits" (a euphemism for the beginnings of bed sores i suppose). A thin film of plastic was placed over the area because "that is better than applying cream". She was having hip and back pains so I went shopping for a small battery powered vibrator/massager which was very effective in easing her pain. A nurse gave her a liquid pain killer rather than the regular Panadol tablets and she found the rapid effectiveness most helpful, even in reducing her tremors (this has been a noticeable effect of Panadol on her PD, I wonder whether others have noticed this?).
On Monday a nurse who had been on leave returned and immediately declared the pedestal fan, that she had been using to ease her temperature fluctuations, "dangerous" and unplugged it. The nurse accused her of having panic attacks and asked what medication she was using for the condition. Just another ignorant professional unaware of some of the side issues of PD. The nurse said that the building was air conditioned so there was no need for extra cooling - I suppose this is why the windows are left open rather than to let in blow flies through the broken screens. Later when a friend visited, the fan was plugged in again and remained that way until she was discharged.
After our initial discussions with the nursing staff there were no further problems about her medication times except one morning a nurse stated that meds were given after "obs", not before. Although on Tuesday because she was in the theatre at noon her meds were delayed until 2pm, then she had to point out that she wished to delay the 6pm meds till 8pm. That night she had little or no sleep. A prisoner and his guard were given a so-called "private" room across the corridor. Lights and a lot of talking kept her awake. On Tuesday afternoon as I was walking past the nurses' station I overhead someone I later learned to be the physio expressing surprise that someone who had been given a skin graft needed to be assessed before being discharged. her inability to get out of bed and stand unaided must have convinced him otherwise.
One afternoon while I was present while she needed 2 nurses to assist her onto a commode chair to be trundled to the loo. I noticed that the nurse (the one who declared the hospital supplied pedestal fan "dangerous") unplug a power cord from the wall while the bed was positioned to position the comode chair. I thought no more about it. Neither did the nurse. In the wee hours of the following morning she found she was unable to adjust the tilt settings of the bed which had at least 4 controls to position separate sections. She was laying in a position that had become uncomfortable to her. No one responded to her alarm which was working this time. After a considerable time a security guard wandered by & asked whether he could help. He found the 3 pin plug on the floor and commented "These beds are worth $6000 and they wreck them by allowing the batteries to discharge."
Another cause of restless sleep during the whole of her time in hospital was due to the 4 bed ward on the other side of the corridor being used as a store room for mobility aids and beds. You need to imagine the lay out of the wards - off each side of a central corridor there are 4 bed wards. There are no doors; instead there are privacy curtains across each ward entrance (the width of the ward) and around each bed. So there is no sound or light proofing between wards and corridor. And at any time of day and night items of equipment are taken to and from the "store room". When she asked why the equipment is stored in the "store room" she was told that the bureaucrats had decreed that this one and only hospital in our town had too many beds for the size of the population so therefore it was deemed necessary to close that ward. Worthy of a mention in that old TV series "Yes Minister". She was able to alert a nurse on Wednesday morning that the prison guard had sat all night in a chair made more comfortable by a pillow he had borrowed from a vacant bed in the adjacent ward. The guard returned the pillow early in the morning. Thoughtful of him, but we do hope some ill patient does not need to lay his/her head upon the pillow in days to come.
The surgeon was agreeable to her being discharged on the Tuesday afternoon but after a physio checked her she needed to show that she was able to walk independently. I had brought in her new collapsible walker with which she practised that night and Wednesday morning. Although we had considered asking for an ambulance or a "disabled" taxi to take her home we settled on our 4WD. Two nurses accompanied us to the vehicle and helped her get in. We were home about 11am.
She found all the hospital staff helpful & attentive, some more so than others and at times some showed signs of tiredness and stress.
At home about bout 1pm she asked me to look at the bed sore area on her bum. There were blood stains on her pants and several small areas were weeping on her right cheek. Once again, supplies left over from the private hospital in Hot Air City came to our aid - a zinc cream preparation for nappy rash and bed sores. I applied a goodly layer of the white tacky stuff. She suddenly felt very tired so I helped her fully clothed into bed; on her side, not her back. Concerned, I rang our friend around the corner in our Village. We discussed a number of alternatives then I settled upon ringing the hospital where I spoke to a junior person who referred to someone senior and I was advised that someone would call me back. Frustratingly, I heard no more until 3pm when our doorbell rang. There stood a strange woman carrying what I thought was a plastic tool box. A District Nurse, contacted by the hospital, had called in on her way to somewhere else. There are aspects of our creaking health system that actually work! I showed the nurse into the bedroom where the patient was waking. The bed sores were inspected. I was to continue applying the zinc cream twice a day. The nurse commented that part of the skin damage had been cause by the sticky tape that had held the plastic "skin" onto the affected area. We had told the hospital that she was allergic to the glue on band-aids. The nurse did not touch the dressings on her graft because she was to visit the surgeon the following day and he is very particular about others interfering with his work. The nurse recommended a large plastic sock to keep the dressings dry while attempting a shower. The nurse planned to return on Friday.
Thursday back to the surgeon for the dressings to be changed. We both saw the graft area for the first time; an area some 6 or 7 cms in diameter that looks dark grey with a matrix pattern upon - I immediately thought of a burn mad by the inside surface of a waffle iron. The experts said this was good, the graft had taken.
The District Nurse returned on Friday, took various details for the inevitable reporting procedures, advised what assistance we can obtain if we need it and she will return once the surgeon feels his part of the job is complete. The nurse also showed us how the use the plastic "legging" that I bought at the chemists. The thing looks like an elephant sized condom. Very comforting to have a caring person show an interest in her problems.
In my view she has reverted back to the condition she was in prior to visits to the physio and her return to the Falls Unit at the hospital and prior to her beginning Sifrol. I am having to help her in and out of bed again, help her to rise from chairs, just like before. Yesterday I helped her shower while seated on her commode shower chair after placing her left leg in the elephant condom. She needed drying and dressing. After that I queried whether she would prefer me to contact family and cancel a planned visit today. She did. Family were understanding.
When I returned from supermarket shopping yesterday afternoon she said "You can do it much more quickly without me."
She has mentioned that a smell is coming from the graft donor site that has been covered in plastic film since Tueday last week. There are no signs of temperature, pain pr throbbing so we just hope there is nothing amiss until she sees the surgeon hopefully for the last time tomorrow.
Today is our 45th wedding anniversary. I hope to take her to the club for lunch although she is not keen. She needs to get out and about. Sitting in a chair all day is little good for her. I on-line ordered some lace embroidery designs for her while in hospital; she is yet to look at the files.
Late update - she did not wish to go out for lunch so we compromised on an afternoon tea at the club.
Did I mention that she developed a slight cough on Friday 31st after a sleepless night? Concerned, I brought in her bouncing ping-pong ball lung exerciser given to her for breathing exercises when she had her kidney operation down in Hot Air City. When a nurse saw/heard her using the device she was told that she could have asked for one as they have them in stock. That is certainly pro-active nursing.
Last Saturday she mentioned to the nurse that her bum area was very tender. Initially ignored, closer inspection revealed 4 small "splits" (a euphemism for the beginnings of bed sores i suppose). A thin film of plastic was placed over the area because "that is better than applying cream". She was having hip and back pains so I went shopping for a small battery powered vibrator/massager which was very effective in easing her pain. A nurse gave her a liquid pain killer rather than the regular Panadol tablets and she found the rapid effectiveness most helpful, even in reducing her tremors (this has been a noticeable effect of Panadol on her PD, I wonder whether others have noticed this?).
On Monday a nurse who had been on leave returned and immediately declared the pedestal fan, that she had been using to ease her temperature fluctuations, "dangerous" and unplugged it. The nurse accused her of having panic attacks and asked what medication she was using for the condition. Just another ignorant professional unaware of some of the side issues of PD. The nurse said that the building was air conditioned so there was no need for extra cooling - I suppose this is why the windows are left open rather than to let in blow flies through the broken screens. Later when a friend visited, the fan was plugged in again and remained that way until she was discharged.
After our initial discussions with the nursing staff there were no further problems about her medication times except one morning a nurse stated that meds were given after "obs", not before. Although on Tuesday because she was in the theatre at noon her meds were delayed until 2pm, then she had to point out that she wished to delay the 6pm meds till 8pm. That night she had little or no sleep. A prisoner and his guard were given a so-called "private" room across the corridor. Lights and a lot of talking kept her awake. On Tuesday afternoon as I was walking past the nurses' station I overhead someone I later learned to be the physio expressing surprise that someone who had been given a skin graft needed to be assessed before being discharged. her inability to get out of bed and stand unaided must have convinced him otherwise.
One afternoon while I was present while she needed 2 nurses to assist her onto a commode chair to be trundled to the loo. I noticed that the nurse (the one who declared the hospital supplied pedestal fan "dangerous") unplug a power cord from the wall while the bed was positioned to position the comode chair. I thought no more about it. Neither did the nurse. In the wee hours of the following morning she found she was unable to adjust the tilt settings of the bed which had at least 4 controls to position separate sections. She was laying in a position that had become uncomfortable to her. No one responded to her alarm which was working this time. After a considerable time a security guard wandered by & asked whether he could help. He found the 3 pin plug on the floor and commented "These beds are worth $6000 and they wreck them by allowing the batteries to discharge."
Another cause of restless sleep during the whole of her time in hospital was due to the 4 bed ward on the other side of the corridor being used as a store room for mobility aids and beds. You need to imagine the lay out of the wards - off each side of a central corridor there are 4 bed wards. There are no doors; instead there are privacy curtains across each ward entrance (the width of the ward) and around each bed. So there is no sound or light proofing between wards and corridor. And at any time of day and night items of equipment are taken to and from the "store room". When she asked why the equipment is stored in the "store room" she was told that the bureaucrats had decreed that this one and only hospital in our town had too many beds for the size of the population so therefore it was deemed necessary to close that ward. Worthy of a mention in that old TV series "Yes Minister". She was able to alert a nurse on Wednesday morning that the prison guard had sat all night in a chair made more comfortable by a pillow he had borrowed from a vacant bed in the adjacent ward. The guard returned the pillow early in the morning. Thoughtful of him, but we do hope some ill patient does not need to lay his/her head upon the pillow in days to come.
The surgeon was agreeable to her being discharged on the Tuesday afternoon but after a physio checked her she needed to show that she was able to walk independently. I had brought in her new collapsible walker with which she practised that night and Wednesday morning. Although we had considered asking for an ambulance or a "disabled" taxi to take her home we settled on our 4WD. Two nurses accompanied us to the vehicle and helped her get in. We were home about 11am.
She found all the hospital staff helpful & attentive, some more so than others and at times some showed signs of tiredness and stress.
At home about bout 1pm she asked me to look at the bed sore area on her bum. There were blood stains on her pants and several small areas were weeping on her right cheek. Once again, supplies left over from the private hospital in Hot Air City came to our aid - a zinc cream preparation for nappy rash and bed sores. I applied a goodly layer of the white tacky stuff. She suddenly felt very tired so I helped her fully clothed into bed; on her side, not her back. Concerned, I rang our friend around the corner in our Village. We discussed a number of alternatives then I settled upon ringing the hospital where I spoke to a junior person who referred to someone senior and I was advised that someone would call me back. Frustratingly, I heard no more until 3pm when our doorbell rang. There stood a strange woman carrying what I thought was a plastic tool box. A District Nurse, contacted by the hospital, had called in on her way to somewhere else. There are aspects of our creaking health system that actually work! I showed the nurse into the bedroom where the patient was waking. The bed sores were inspected. I was to continue applying the zinc cream twice a day. The nurse commented that part of the skin damage had been cause by the sticky tape that had held the plastic "skin" onto the affected area. We had told the hospital that she was allergic to the glue on band-aids. The nurse did not touch the dressings on her graft because she was to visit the surgeon the following day and he is very particular about others interfering with his work. The nurse recommended a large plastic sock to keep the dressings dry while attempting a shower. The nurse planned to return on Friday.
Thursday back to the surgeon for the dressings to be changed. We both saw the graft area for the first time; an area some 6 or 7 cms in diameter that looks dark grey with a matrix pattern upon - I immediately thought of a burn mad by the inside surface of a waffle iron. The experts said this was good, the graft had taken.
The District Nurse returned on Friday, took various details for the inevitable reporting procedures, advised what assistance we can obtain if we need it and she will return once the surgeon feels his part of the job is complete. The nurse also showed us how the use the plastic "legging" that I bought at the chemists. The thing looks like an elephant sized condom. Very comforting to have a caring person show an interest in her problems.
In my view she has reverted back to the condition she was in prior to visits to the physio and her return to the Falls Unit at the hospital and prior to her beginning Sifrol. I am having to help her in and out of bed again, help her to rise from chairs, just like before. Yesterday I helped her shower while seated on her commode shower chair after placing her left leg in the elephant condom. She needed drying and dressing. After that I queried whether she would prefer me to contact family and cancel a planned visit today. She did. Family were understanding.
When I returned from supermarket shopping yesterday afternoon she said "You can do it much more quickly without me."
She has mentioned that a smell is coming from the graft donor site that has been covered in plastic film since Tueday last week. There are no signs of temperature, pain pr throbbing so we just hope there is nothing amiss until she sees the surgeon hopefully for the last time tomorrow.
Today is our 45th wedding anniversary. I hope to take her to the club for lunch although she is not keen. She needs to get out and about. Sitting in a chair all day is little good for her. I on-line ordered some lace embroidery designs for her while in hospital; she is yet to look at the files.
Late update - she did not wish to go out for lunch so we compromised on an afternoon tea at the club.
posted by Kilpike | 7:38 am
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